Physical work load and psychological stress of daily activities as predictors of disability pension due to musculoskeletal disorders

Aims: Physical work loading and psychological stress commonly co-occur in working life, hence potentially having an interrelationship that may affect work incapacity. This prospective cohort study aimed to investigate the effect of stability and change in physical work loading and stress on the risk of disability pension (DP) due to musculoskeletal diagnoses (MSD), while accounting for familial confounding in these associations. Methods: Data on 12,455 twins born before 1958 were surveyed of their physical work loading and psychological stress of daily activities in 1975 and 1981. The follow-up data was collected from pension registers until 2004. Cox proportional hazards regression models were used. Results: During the follow up, 893 participants were granted DP due to MSD. Stable high (hazard ratio, HR, 2.21), but also increased physical work loading (HR 2.05) and high psychological stress (HR 2.22) were associated with increased risk for DP, and had significant interaction (p=0.032). The associations were confirmed when accounting for several confounding factors. Conclusions:Stable high but also increased physical work loading and psychological stress of daily activities between two timepoints with 6 years apart confirms their predictive role for an increased risk of DP. Both physical work loading and psychological stress seem to be independent from various confounding factors hence suggesting direct effect on risk for DP providing potential for occupational health care to early identification of persons at risk.